Vitamins may not be that helpful. That is the headline that comes from the most recent US Preventative Task Force’s Recommendation Statement published in JAMA on the evidence of benefit to harm of vitamin supplements. As is our wont, we should dig a little deeper…

The vitamin industry is big. A Google search will yield a low of $1.5 billion to a high of $30 billion spent in the US annually on vitamins. In this analysis, 52% of Americans claimed to take vitamins of one sort or another. The USPTF updated it’s 2014 recommendation after analysis of studies performed since then and reached the same conclusion as they did before: there is no evidence of benefit of most vitamins in preventing heart disease, cancer, or all cause mortality. They did find some supplements that cause harm. Beta carotene (which gets converted to vitamin A in the body) as well as vitamin E were considered to be harmful.

Of course we should say this applies to non-pregnant adults. (Pregnant women can benefit from folate supplementation to prevent fetal neural tube defects).

However if you look at the quality of evidence it’s pretty poor. Even the risks of harm associated with beta carotene and vitamin E are given a Grade D. And that’s the BEST they do. The quality of evidence for the lack of effect of vitamins is given a Grade I (Insufficient). That’s even worse than a Grade D! When the harms of vitamins was analyzed it, too, received an “I”as there is no evidence that vitamins cause harm (other than the two aforementioned).

So how does one interpret such good quality research regarding poor quality evidence? I think there are several take home points:

1) If you are taking routine beta carotene or vitamin E, you should stop until you talk to your doctor.

2) If you are not taking a vitamin supplement, your not missing anything

3) If you are taking a vitamin supplement and you don’t feel any better about anything, you can probably stop if you want to

and finally, I think a very important

4) If you are taking a vitamin supplement and you feel good about it, there is no evidence of harm, and you can keep on taking it.

As John Lennon (who’s compatriot Paul just turned 80 last Saturday) said:

“Whatever gets you through the night it’s all right, it’s all right.”